National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States.
Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, Marshfield, WI, United States.
JMIR Hum Factors. 2024 Jun 24;11:e55443. doi: 10.2196/55443.
Physicians and patient-facing caregivers have increasingly used mobile health (mHealth) technologies in the past several years, accelerating during the COVID-19 pandemic. However, barriers and feedback surrounding adoption remain relatively understudied and varied across health systems, particularly in rural areas.
This study aims to identify provider adoption, attitudes, and barriers toward mHealth in a large, multisite, rural US health care system. We investigated (1) mHealth apps that providers use for their own benefit and (2) mHealth apps that a provider uses in conjunction with a patient.
We surveyed all patient-seeing providers within the Marshfield Clinic Health System with a brief, 16-item, web-based survey assessing attitudes toward mHealth, adoption of these technologies, and perceived barriers faced by providers, their peers, and the institution. Survey results were summarized via descriptive statistics, with log-binomial regression and accompanying pairwise analyses, using Kruskal-Wallis and Jonckheere-Terpstra tests for significance, respectively. Respondents were grouped by reported clinical role and specialty.
We received a 38% (n/N=916/2410) response rate, with 60.7% (n=556) of those sufficiently complete for analyses. Roughly 54.1% (n=301) of respondents reported mHealth use, primarily around decision-making and supplemental information, with use differing based on provider role and years of experience. Self-reported barriers to using mHealth included a lack of knowledge and time to study mHealth technologies. Providers also reported concerns about patients' internet access and the complexity of mHealth apps to adequately use mHealth technologies. Providers believed the health system's barriers were largely privacy, confidentiality, and legal review concerns.
These findings echo similar studies in other health systems, surrounding providers' lack of time and concerns over privacy and confidentiality of patient data. Providers emphasized concerns over the complexity of these technologies for their patients and concerns over patients' internet access to fully use mHealth in their delivery of care.
在过去几年中，医生和面向患者的护理人员越来越多地使用移动医疗（mHealth）技术，在 COVID-19 大流行期间更是如此。然而，围绕采用这些技术的障碍和反馈在不同的医疗系统中仍然相对研究不足，特别是在农村地区。
本研究旨在确定大型多地点美国医疗保健系统中医疗服务提供者对 mHealth 的采用、态度和障碍。我们调查了（1）提供者为自身利益而使用的 mHealth 应用程序，以及（2）提供者与患者一起使用的 mHealth 应用程序。
我们通过一个简短的、基于网络的 16 项调查，向 Marshfield Clinic Health System 的所有患者服务提供者进行了调查，评估他们对 mHealth 的态度、这些技术的采用情况以及提供者、其同行和机构面临的感知障碍。使用对数二项式回归和相应的配对分析，分别使用 Kruskal-Wallis 和 Jonckheere-Terpstra 检验进行显著性检验，对调查结果进行了总结。受访者根据报告的临床角色和专业进行分组。
我们收到了 38%（n/N=916/2410）的回复率，其中 60.7%（n=556）的回复足够完整可供分析。大约 54.1%（n=301）的受访者报告使用 mHealth，主要用于决策和补充信息，使用情况因提供者角色和经验年限而异。自我报告使用 mHealth 的障碍包括缺乏知识和学习 mHealth 技术的时间。提供者还报告了对患者互联网接入和 mHealth 应用程序复杂性的担忧，以充分使用 mHealth 技术。提供者认为医疗系统的障碍主要是隐私、保密性和法律审查方面的问题。
这些发现与其他医疗系统中的类似研究相呼应，主要涉及提供者缺乏时间以及对患者数据隐私和保密性的担忧。提供者强调了对这些技术对患者的复杂性的担忧，以及对患者充分使用 mHealth 进行护理的互联网接入的担忧。
